How do you spot a toxic workplace? These clinicians share their tips

November is National Diabetes Month. Join me on Wednesday for a discussion on the latest in treatment and prevention. Click on the image below to register and I hope to see you there!

Now on to this week's issue.

It’s evident to anyone who works in the healthcare profession these days that working conditions can be downright toxic, as I reported last week .

Clinicians have been quitting their jobs in large numbers – sometimes to become free agents, of sorts, working on travel contracts – leaving those who remain to grapple with staffing shortages or a revolving door of coworkers. Connection and community may be one of the pillars of a healthy work environment, according to the Surgeon General’s recent framework, but that’s harder to foster in a high-turnover workplace.?

?“A need to work with many travelers, … instead of cohesive teams, is a very stressful and less safe environment – where the doctor is still ultimately liable and responsible,” wrote Dr. Helen Miller MD, MBA, CPE, CEM a physician and consultant, in a comment on LinkedIn.

The challenges of working in healthcare have been well documented by now. What I wanted to explore this week, therefore, is whether there are ways to determine if an employer is a toxic place to work before accepting a job offer.

Compared with other industries, the stakes of accepting a new job are arguably higher for healthcare professionals, who are often asked to sign contracts with restrictive covenants, like noncompete agreements.

Employer review sites do exist, but they don’t necessarily capture the questions that are most important to clinicians – like the level of respect that administrators have for their input, said Gaspere C Geraci, MD , a physician and consultant who created the site Rate Your Healthcare Employer about a year and a half ago to help meet that need. One theme that I’ve heard again and again – especially from physicians – is a frustration with the lack of autonomy they’re given in their roles.

“I would talk to groups of doctors and I’d ask, ‘How many of you are happy?’” Geraci told me. “And literally one or two would raise their hands.”

In comments last week, a number of you acknowledged the difficulty of getting a pulse on an employer through the job interview process alone.???

“I prefer to join an organization where someone I know personally or professionally could vouch for the environment,” wrote Marjorie Feria, BSN, RN, NC-BC, BSC , an operating room nurse. “Most nurse interviews occur outside of the department so you can’t even get a feel for the ‘vibe’ of the place.”

Even still, there may be ways to get an inside look – or at least identify red flags – by asking pointed questions. Here are some of the tips suggested:

“One question I may ask to evaluate company culture is, ‘How has this organization supported its workforce mentally or emotionally in the last two years?’” said Dr. Blair Thielemier, PharmD , a pharmacist and consultant. “If the answer is pizza parties, run!”

Dr. Cheree Caesar, PharmD , another pharmacist, suggested looking at employee retention. “In the future, I would ask, ‘How long did the last person in this position stay in this job and why did they leave?’” she wrote in a comment on LinkedIn.

Sometimes managers tip their hands in the way they discuss their employees. “How does management speak about them? As an asset or a problem?”? wrote Aldebra Schroll MD , a palliative care physician.??

And make sure to ask about expectations for working after hours. “I’ve had to turn down roles in recent weeks for this reason,” wrote Kirsten Evans, MA, LBS ?? , a behavioral health professional. “One interviewer literally told me, ‘You need to be checking your email 24/7.’ No, thanks.”

Geraci of Rate Your Healthcare Employer acknowledged that uptake has been slow, perhaps because doctors, nurses and PAs are concerned about the possibility of retaliation. Still, he believes it’s important to share experiences, if not with his site, then with others that have popped up and are similarly trying to meet the need.

“The way we can force a bad employer to become better is to choke off their supply,” he said. “If we can impact their ability to hire, toxic employers will have to [improve] or they’ll be stuck with hiring the worst of the worst.”

What do you think of these tips? What would you add?